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      Diet, Physical Activity and Gestational Weight Gain Patterns among Pregnant Women Living with Obesity in the North East of England: The GLOWING Pilot Trial

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          Abstract

          Maternal diet, physical activity (PA) behaviours, and gestational weight gain (GWG) are important for optimum health of women and their babies. This secondary analysis of the GLOWING pilot cluster trial explored these among women living with obesity in high deprivation. Pregnant women completed food frequency, PA and psychosocial questionnaires. Weights were retrieved from medical records and measured during routine appointments with midwives. Descriptive and regression analyses were stratified by obesity class. A total of 163 women were recruited; 54.0% had class 1 obesity, 25.8% class 2, 20.2% class 3, and 76.1% lived in the two most deprived quintiles. Women had suboptimal dietary intake, particularly for oily fish, fruit and vegetables. PA was predominantly light intensity, from household, care and occupational activities. Most women gained weight outside of Institute of Medicine (IOM) guideline recommendations (87.8%); women in class 3 obesity were most likely to have inadequate GWG below IOM recommendations (58.3%, p < 0.01) and reduced odds of excessive GWG compared with class 1 (AOR 0.13, 95% 0.04–0.45). Deprived women with obesity have a double inequality as both increase pregnancy risks. This population requires support to meet guideline recommendations for diet, PA and GWG. Further research exploring obesity classes would inform policies and care to achieve the best pregnancy outcomes.

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          Most cited references63

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          Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

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            Compendium of Physical Activities: an update of activity codes and MET intensities

            We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.
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              No Adjustments Are Needed for Multiple Comparisons

              Adjustments for making multiple comparisons in large bodies of data are recommended to avoid rejecting the null hypothesis too readily. Unfortunately, reducing the type I error for null associations increases the type II error for those associations that are not null. The theoretical basis for advocating a routine adjustment for multiple comparisons is the "universal null hypothesis" that "chance" serves as the first-order explanation for observed phenomena. This hypothesis undermines the basic premises of empirical research, which holds that nature follows regular laws that may be studied through observations. A policy of not making adjustments for multiple comparisons is preferable because it will lead to fewer errors of interpretation when the data under evaluation are not random numbers but actual observations on nature. Furthermore, scientists should not be so reluctant to explore leads that may turn out to be wrong that they penalize themselves by missing possibly important findings.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                09 June 2021
                June 2021
                : 13
                : 6
                : 1981
                Affiliations
                [1 ]Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; lem.ngongalah@ 123456newcastle.ac.uk (L.N.); judith.rankin@ 123456newcastle.ac.uk (J.R.); elaine.mccoll@ 123456newcastle.ac.uk (E.M.)
                [2 ]Department of Women and Children’s Health, Kings College London, Strand, London WC2R 2LS, UK; angela.flynn@ 123456kcl.ac.uk (A.C.F.); kathryn.dalrymple@ 123456kcl.ac.uk (K.V.D.)
                [3 ]Faculty of Health and Life Sciences, Northumbria University, Sutherland Building, Newcastle upon Tyne NE1 8ST, UK; catherine.mcparlin@ 123456northumbria.ac.uk
                [4 ]Leeds Institute of Health Sciences, University of Leeds, Woodhouse, Leeds LS2 9JT, UK; k.e.best@ 123456leeds.ac.uk
                Author notes
                Author information
                https://orcid.org/0000-0001-8438-1506
                https://orcid.org/0000-0001-6920-7622
                https://orcid.org/0000-0003-4144-8218
                https://orcid.org/0000-0003-0958-6725
                Article
                nutrients-13-01981
                10.3390/nu13061981
                8227571
                34207613
                e99730ed-7ade-4c13-9b47-c88d62eb7be1
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 15 April 2021
                : 04 June 2021
                Categories
                Article

                Nutrition & Dietetics
                pregnancy,obesity,diet,physical activity,gestational weight gain,deprivation
                Nutrition & Dietetics
                pregnancy, obesity, diet, physical activity, gestational weight gain, deprivation

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