Nutrition Behaviour During Pregnancy: Eating Twice as Healthy? A Secondary Analysis of the Nutrition Component of the NELIP Randomized Controlled Trial.

Background/Objectives: To examine adherence to the specific goals of the nutrition component of a healthy lifestyle intervention program during pregnancy (the Nutrition and Exercise Lifestyle Intervention Program; NELIP) from baseline at 12-18 weeks gestation to trial midpoint (24-25 weeks gestation) and endpoint (34-36 weeks gestation). Methods: A convenience sample of 90 individuals were included in the secondary analysis. Participants completed the pregnancy intervention in one of three groups: NE, nutrition and exercise introduced simultaneously; N+E, nutrition introduced first followed by exercise introduced at midpoint; or E+N, exercise introduced first followed by nutrition introduced at midpoint. A meal plan with guidelines for carbohydrate and protein consumption was included in the nutrition component, and adherence to the specific meal plan goals was tracked using a novel rubric developed especially for the meal plan in the NELIP intervention. Results: All groups had improvements in nutrition adherence from baseline to midpoint, with the NE group scoring highest in adherence (12.9 ± 2.0 points) at midpoint compared to the N+E (11.2 ± 1.8 points) and E+N (11.8 ± 2.0 points) groups (F(2, 85) = 6.08, p = 0.00, η2 = 0.13). From midpoint to endpoint, N+E was the only group with no decline in adherence. Conclusions: The N+E group had the most stable improvements in adherence over the course of the intervention, despite better improvements in adherence from baseline to midpoint in groups NE and E+N. Time of intervention component introduction may have a differential impact on adherence score fluctuation, with baseline nutrition scores potentially influencing nutrition habits over time.